Glucose intolerance and primary hyperparathyroidism: an unresolved relationship.

Primary hyperparathyroidism (PHPT) can be characterized as either symptomatic or asymptomatic, or, most recently, as normocalcemic. In the current issue of the journal, Cakir et al. report that insulin resistance and glucose intolerance is not an aspect of normocalcemic PHPT. However, both the current study as well as the literature are compromised by the lack of appropriate classification of normocalcemic PHPT subjects. Rigorously characterized cohorts are necessary to determine whether glucose intolerance is in fact present in normocalcemic PHPT.